STOMACH CANCERSTOMACH CANCERMaria G. Nelson

The StomachThe StomachHollow organ in the upper abdomen,

under the ribs5 layers:

◦ Inner layer – where most stomach cancer begins

◦Submucosa – support tissue for the inner layer◦Muscle layer – create a rippling motion that

mixes and mashes food◦Subserosa – support tissue for the outer layer◦Outer layer (serosa) – covers the stomach and

hold it in place

Benign TumorsBenign TumorsAre not cancerNot life-threateningCan be removed and usually do

not grow backCells do not invade the tissues

around themCells do not spread to other parts

of the body

Malignant Tumors Malignant Tumors Are cancerGenerally more serious than benign

tumorsMay be life-threateningOften can be removed but

sometimes grow backCells can invade and damage nearby

tissues and organsCan spread (metastasize) to other

parts of the body

Stomach CancerStomach CancerCan affect nearby organs and

lymph nodesStomach tumor can grow through

stomach’s outer layer into nearby organs (such as the pancreas, esophagus or intestine)

Can spread through the blood to the liver, lungs and other organs

Can also spread through the lymphatic system to lymph nodes all over the body

Stomach CancerStomach Cancer

Risk FactorsRisk Factors Exact causes unknown Age – most are age 72 or older Sex – men most likely than women Race – more common in Asian, Pacific Islander,

Hispanic and African-Americans Diet – diet high in foods that are smoked, salted

or pickled Helicobacter pylori infection – raises risk of

stomach inflammation and stomach ulcers Smoking – people who smoke more at risk Certain health problems: stomach surgery,

chronic gastritis, pernicious anemia. Family history – rare type of stomach cancer runs

in some families

SymptomsSymptomsEarly stomach cancer – no clear

symptomsDiscomfort in the stomach areaFeeling full or bloated after a small

mealNausea and vomitingWeight lossOther health problems, such as ulcer

or infection, can cause the same symptoms.

DiagnosisDiagnosisPersonal and family health historyPhysical exam – checks abdomen for

fluid, swelling or other changesUpper GI series – x-rays of

esophagus and stomachEndoscopy – use of a thin, lighted

tube (endoscope) to look into the stomach

Biopsy – checks tissue sample under a microscope for cancer cells

Other TestsOther TestsBlood tests – CBC to check for

anemia and how the liver is workingChest x-ray – checks for tumors in

the lungsCT scan – detailed pictures of the

organsEndoscopic ultrasound Laparoscopy – small incisions in the

abdomen. The surgeon may remove lymph nodes or take tissue samples for biopsy.

Stages of Stomach CancerStages of Stomach CancerStage 0 – cancer found only in

the inner layer of the stomachStage 1

◦Tumor invaded only the submucosa – cancer cells may be found in up to 6 lymph nodes

◦Tumor invaded the muscle layer or the subserosa

◦Cancer cells have not spread to lymph nodes or other organs

Stages of Stomach CancerStages of Stomach CancerStage II

◦Tumor has invaded only the submucosa – cancer cells have spread to 7-15 lymph nodes

◦Tumor has invaded the muscle layer or subserosa – cancer cells have spread to 1-6 lymph nodes

◦Tumor has penetrated outer layer of the stomach

◦Cancer cells have not spread to lymph nodes or other organs

Stages of Stomach CancerStages of Stomach CancerStage III

◦Tumor has invaded the muscle layer or subserosa – 7-15 lymph nodes or

◦Tumor has penetrated the outer layer – 1-15 lymph nodes

◦Tumor has invaded nearby organs, such as the liver or spleen

◦Cancer cells have not spread to lymph nodes or distant organs

Stages of Stomach CancerStages of Stomach CancerStage IV

◦Cancer cells have spread to more than 15 lymph nodes or

◦Tumor has invaded nearby organs and at least 1 lymph node

◦Cancer cells have spread to distant organs

Recurrent cancer◦Has come back◦May recur in the stomach or in another

part

TreatmentTreatmentLocal therapy - removes or destroys

cancer in or near the stomach◦Surgery – either partial or total

gastrectomy◦Radiation – uses high energy rays to kill

cancer cellsSystemic therapy – the drug enters

the bloodstream and destroys or controls cancer throughout the body◦Chemotherapy – uses anticancer drugs

TreatmentTreatmentComplementary and alternative

medicine (CAM)◦Acupuncture◦Massage therapy◦Herbal products◦Vitamins or special diets◦Visualization◦Meditation◦Spiritual healing

Nursing ManagementNursing ManagementDiscuss situation and provide information

about all procedures and treatment. Help client talk about feelings or concerns

about illness.Discuss current and planned treatment

measures.Stress the importance of completing the

prescribed treatments.Discuss stress reduction techniques and

refer for stress reduction counseling or workshops as indicated.

Help arrange meeting with social worker, counselor or member of the clergy if needed.